How can you control staff attitude? You can't control it. You can only foster it, develop it and encourage it. Ruling employees with an iron fist is not the best approach for a professional service business like ours. I advise practice owners and managers to think about employees as if they are internal customers. Just as we care about customers' wants and needs, we should do the same for employees. Ask yourself why an employee should choose to work in your practice over all the other jobs in the area? What is so great about working in your office? Owners and managers expect employees to be happy and friendly all the time – but what's in it for the worker? Is it the pay and benefits? If not that, then what else is there? The other things revolve around organizational culture and asking questions like these is the first step to improving it.

Organizational culture

One of the most important things you can do to enhance practice success is to develop a positive organizational culture. But how do you do that, exactly? Most of us are not even sure what it is. Organizational behavior is a complex subject, but if we simplify it for purposes of this newsletter, we can assume it refers to how employees feel about their job and the unwritten rules that govern how things are done at work. It's important because your office culture is the key factor that influences staff attitude and we all know the huge impact that has on patient service.

A friendly, caring staff member creates loyal, happy patients who buy more and refer more. A grouchy, rude employee causes patients to complain about fees at best and to change doctors at worst.

Look within

Evaluate your practice with regard to the following elements of organizational culture. Consider asking a high level staff member for objective input.

Job satisfaction. How well employees like their job depends on many factors, some of which are listed below. Do your employees take pride in their work? Do they feel like their ideas matter and that the boss cares what they think? Is anyone interested in them – personally and professionally? How is their self-worth?

Respect. Do doctors, owners, managers and other high level employees show respect for each other and for the staff members they supervise? Mutual respect for co-workers will only exist if senior personnel practice it themselves every day.

Integrity. Review your office policies and behavior to be sure patients, insurance companies, suppliers, service firms and all contacts are handled in an ethical and moral way. Employees observe all the behind the scenes activities, even ones you might think no one sees. Employees mirror the behavior they see.

Fairness. Work continuously to treat employees equally and fairly. This can be difficult when you are trying to be caring and compassionate and an employee asks for special considerations. You can say yes to some special requests and still be fair to all. Just try to apply the rules to all in similar situations and hold firm when important rules are challenged. For example, an employee who calls off work frequently is not being fair to others. The same is true for the chronically late employee. Issues like these should not be tolerated. Termination could be the end result after a sincere effort to remediate the problem.

Policies. Employees need to have rules and limits and it is best to have them in writing. Start with your policy for sick days, personal days and vacation days. Who gets them? How many? How are they taken? When can't they be used? What happens to them at the end of the year? If you don't have policies such as these – make them up and write them down.

Leadership. The practice owner, doctor and manager have leadership by default but it must be exercised wisely. The practice leaders are always setting an example and they should make decisions based on what's best for the practice. A passionate belief in excellent customer service for patients and in creating a pleasant work environment are two values that will take you in the right direction as a leader.

How chummy should you be?

Optometrists have asked me how close they should be with their staff members. I think that is an enlightened question. At least these practitioners are moving beyond a stone wall of silence and disinterest that separates some practitioners from their staffs. But there is concern that if the practice owner takes an interest in the personal lives of employees that a personal friendship may develop or try to develop.

There is probably room for all kinds of relationships; there are many examples of husband and wife teams that succeed along with many more relationships. In general, however, it may not be advisable for the boss to be a close friend to a worker, in my opinion. I think a genuine interest in the personal lives of employees is a good thing. Taking time to ask staff members about their families and their personal interests develops a congenial office culture. The relationship can remain office-based and need not extend into after work times, except for the occasional office social activity which is open to all staff.

I would be pleased to see friendships develop among co-workers. I am tolerant of some personal conversations in the office as long as they are kept in balance with work and never allowed to be seen or heard by patients. We want the office to be a pleasant place to work and it's smart to view it from the staff member's point of view.